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Individual

AKILA FANA BACON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1529 E PALMDALE BLVD STE 210, PALMDALE, CA 93550-2029
(818) 523-2379
Mailing address
6490 EXPLORER WAY, PALMDALE, CA 93552-3454
(818) 523-2379

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
AMFT110989
CA
101YM0800X
Mental Health Counselor
IMF73718
CA
101YM0800X
Mental Health Counselor
Primary
LMFT139465
CA

Other

Enumeration date
08/09/2011
Last updated
07/02/2023
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